A comparison of a generic and oral health–specific measure in assessing the impact of early childhood caries on quality of life

Lee GHM, McGrath C, Yiu CKY, King NM. A comparison of a generic and oral health–specific measure in assessing the impact of early childhood caries on quality of life. Community Dent Oral Epidemiol 2010; 38: 333–339. © 2010 John Wiley & Sons A/S Abstract – Objectives: The aim of this study was to compare the performance of a generic health‐related quality‐of‐life measure, the Pediatric Quality of Life Inventory Version 4.0 (PedsQL? 4.0) and an oral health–specific quality‐of‐life measure, the Early Childhood Oral Health Impact Scale (ECOHIS) in assessing the impact of severe early childhood caries (S‐ECC) on the children’s quality of life. Methods: A trained and calibrated examiner conducted a clinical oral assessment of 111 children (mean age: 49 ± 12 months): 64 of whom were categorized as having S‐ECC and 47 as being caries‐free. Primary caregivers completed a Chinese version of the PedsQL? 4.0 and the ECOHIS. Clinical examinations were conducted blind of the parental assessments. Results: The ECOHIS scores were significantly higher for the S‐ECC group than for the caries‐free group (P ≤ 0.001). No significant difference was found between the PedsQL? 4.0 scores in relation to caries status, except for the subscale of physical functioning (P = 0.04). Correlation of caries status with the ECOHIS scores was strong (r = 0.66; P < 0.01). No significant correlation was found between PedsQL? 4.0 scores and caries status (r = 0.02; P > 0.05). Conclusions: The oral health–specific measure, ECOHIS, shows better discriminant property between children with S‐ECC and caries‐free children than the generic measure, PedsQL? 4.0. The ECOHIS appears more sensitive than PedsQL? 4.0 in assessing the impact of dental caries on the life quality of preschool children.     

Cochlear implant in Hong Kong Cantonese

Cochlear implant surgery was performed in four Cantonese-speaking postlingually deaf Chinese adults, using the House/3M single channel device. This article outlines the methodology, including preoperative assessment and postoperative rehabilitation; and explains the necessary modifications in speech and audiologic work-up in Cantonese-speaking patients. Salient features of Cantonese phonetics, especially its tonal characteristics, are described. The findings of the study are presented. The results of the cochlear implant would suggest a performance superior to that of the hearing aid. Furthermore, the cochlear implant is able to detect tonal cues. This quality of the cochlear implant may prove to be a valuable asset to a tonal language-speaking cochlear implantee.     

Liver transplantation in tyrosinaemia type 1: the dilemma of timing the operation

Four children with tyrosinaemia type 1 received liver transplants. The metabolic disorder was corrected and all four had normal liver function on an unrestricted diet. Two children, transplanted at age five and seven years, proved to have occult hepatocellular carcinoma and both subsequently developed pulmonary metastases. One child was well 32 months after removal of a single pulmonary metastasis but the other child died with multiple metastases. The two younger children, transplanted at age 19 and 21 months, were well 28 and 44 months after operation, one after a second liver transplant. Our experience confirms the high risk of hepatocellular carcinoma in this disease and the potential value of early liver transplantation.     

Acute appendicitis in the elderly

A prospective study was done on 104 patients more than 60 years old with appendicitis. The clinical features are by and large, similar to that of the younger patient. However, four patients presented atypically with abdominal distension with little or no pain. A statistically significant increase in appendiceal perforation is found in patients more than 70 years old and in patients with prolonged delay in operation. However, delay on the part of the surgeon contributed only slightly to the high appendiceal perforation as 85.6 per cent of patients who were operated upon within 24 hours of admission. Appendicitis in the elderly patient appeared to progress to perforation faster and perforation occurred in about 40 per cent of patients within 24 hours of onset of symptoms. Five patients died and 29 postoperative complications occurred in 24 more patients. An associated medical disease is linked to a statistically significant increase in mortality. Appendiceal perforation and a total delay of more than 37 hours are associated with a statistically significant increase in morbidity.